Many of us are learning to address global health concerns by taking a systems view rather than looking at specific, isolated issues or interventions.By partnering with ministries of health and tailoring solutions that are affordable and deliverable, we are successfully scaling more integrated, permanent solutions. Systems change strategy implementation is proving effective with global health groups including End Malaria Council, END Fund (e.g., neglected tropical diseases), the Office of the UN Special Envoy for Health (e.g., community health activities), and many others. While the systems change model continues to evolve, learnings from the health sector are being applied to broader areas including slavery, refugees, and education.
Systems change uses tools such as system and road maps, orchestrators and change agents, return on investment analyses, dialogues to establish common measurable outcomes and goals, and pathways for action. These resources enable country leaders, foundations, nonprofits, corporations, multilateral and bilateral funders, and agencies to work together to achieve significant outcomes. Through this approach, the problem is mutually agreed upon by stakeholders. Together they identify innovations to be applied and then design scaled applications that lead to permanent change.
Systems change successes from the community health space include:
Funding ministry leadership training through the Aspen Management Partnership for Health;
- Designing financing for health systems through the Financing Alliance for Health;
- Donor collaborations focused on specific country efforts (e.g., Liberia, Malawi, and Uganda);
- Tracking data for accountability and progress on malaria and other diseases through ALMA;
- Working with policy makers at the World Health Organization;
Synthesizing practitioner experience through CHW Impact Coalition and other partners.
These activities (left) form an aligned and holistic approach aimed at achieving a common systems change goal—scaling up 1 million community health workers to reduce maternal and child mortality.
Tasking orchestrators and change agents to help define and steer holistic activities will increase the odds of success. They not only ensure the strategic approach, but also amplify the voice and needs of country leaders, bring together funders in the space, help ensure stakeholder alignment, share knowledge, and measure impact.
Increasingly, funding by philanthropists is available to hire the small numbers of people needed who can apply systems change tools and increase our ability to address complex, large scale health challenges.